L'exploration de l'homme du couple infécond

The exploration of male infertility combines clinical examination and complementary analysis, including biology and ultrasonography. The purpose of this review is to analyze the data available on the accuracy of interview, testicular ultrasonography, sperm analysis and post-coital test. Medical history and patient's interview remain central in the exploration of the infertile man. Despite some limitations, studies on testicular sonography confirm the high prevalence of testicular lesions in infertile men. Up to now, sperm analysis remains the pivotal element of the exploration of male fertility. The new WHO manual for semen analysis published in 2010 should help in redefining its place in the global exploration of male infertility. Despite its statutory character in France, the interest of systematic sperm bacterial examination remains to be demonstrated. Concerning sperm DNA fragmentation, its use as a first-line test should not be recommended. Finally, high levels of evidence do not exist concerning the use of post-coital test as a predictor of pregnancy in infertile couples.